DOI: 10.15986/j.1008-7192.2020.01.008
以城镇职工基本医疗保险为例,在征管机构改革背景下,探究其缴费率在短期(2019-2025年)和中期(2019-2050年)内是否可以下调,并测算下调空间。研究发现:如果不进行征管机构改革,职工医保统筹基金将于2034年出现累计结余赤字,缴费率在短期内可以下调至5.7%,下调空间为2.3%,但在中期内不具备下调空间,需提高4.66%以维持基金收支平衡; 征管机构改革后,在短期内仍可下调缴费率,此时下调空间扩大至2.76%,中期内不具备下调空间,但提高幅度降为3.63%; 在征管机构改革背景下进一步引入延迟退休年龄政策,短期内的下调空间进一步扩大至2.89%,中期内仍不具备下调空间,提高幅度进一步降为2.15%。上述结论均通过敏感性检验。导致这一结果的主要原因是职工医保基金支出增长率过高,对此政府应该着眼于中期,建议尽快出台延迟退休年龄方案,注意减少不合理的医疗费用支出,积极探索并完善医保及相关制度。
In the context of collection agency reform and the case of China's basic medical insurance for urban employees, the paper explores whether the contribution rate can be reduced in the short-term(2019+2025)and the medium-term(2019-2050), and estimates the degree of reduction. The results are as follows: unless the reform of the collection agency is carried out, the pooling fund of medical insurance for employees will move into accumulative balance deficit in 2034 The contribution rate can be reduced to 5.7% in the short term with a reduction of 2.3%. However, there is no room for reduction in the medium term, and a rate increase of 4.66% is needed to maintain the balance of the fund; after the reform of the collection agency, the contribution rate can still be reduced in the short term when the reduction is expanded to 2.76%. In the medium term, there is no room for reduction, but the increase rate goes down to 3.63%; under the background of collection agency reform, it is necessary to further introduce the policy of extending retirement age, thus expanding the reduction to 2.89% in the short term. As there is still no room for reduction in the medium term, the increase rate is further reduced to 2.15%. The above findings have passed the sensitive test. The main reason for this result is the excessive growth rate of expenditure on employees' medical insurant fund. In this regard, it is important that the government should have the medium-term in mind, and pay attention to implementing the policy to extend the retirement age as soon as possible, lower the unreasonable medical expenses and improve actively the medical insurance and related systems.
